Researchers are investigating personalized treatment approaches for post-infectious irritable bowel syndrome (IBS). This type of IBS occurs after a person experiences a gastric infection, such as norovirus, food poisoning, or COVID-19. Treatments may involve antibiotics and probiotics. A team in Italy conducted a pilot trial where they sequenced the gut microbiome of IBS patients and used an individualized combination of antibiotics, prebiotics, and probiotics to treat symptoms. This precision approach resulted in improved symptoms for a small group of 13 participants with IBS.
In the pilot trial, researchers analyzed the gut microbiomes of individuals with post-infectious IBS and treated overgrowth of certain bacteria with antibiotics. They also addressed deficiencies in certain bacterial strains with specific probiotics and prebiotics to create a balanced gut environment. Over a third of those treated in this personalized way experienced complete remission of their symptoms 12 weeks after starting treatment. Researchers presented their non-peer-reviewed results at a conference in Spain.
The treatment included prescribing antibiotics to reduce pathogenic bacteria levels, probiotics to increase beneficial strains, and prebiotics such as inulin and psyllium to two-thirds of participants. After 12 weeks, 12 out of 13 participants reported an improvement in symptoms, with five experiencing total remission. Researchers found low species diversity, imbalances in specific bacterial strains, and low levels of certain bacteria in the microbiomes of the participants.
Post-infectious IBS is a form of IBS that develops after a bacterial or viral infection in the gastrointestinal tract. This condition can lead to symptoms similar to IBS, such as recurrent pain and changes in bowel habits. It is distinct from inflammatory bowel disease (IBD), which involves damage to the intestines due to an immune system response. There is currently a poor understanding of why some individuals develop post-infectious IBS while others do not.
When individuals experience a gastric infection, the nociceptive receptors in the gut become sensitized and can lead to persistent symptoms of pain and discomfort. This sensitization may be a key factor in the development of post-infectious IBS. While the personalized treatment approach used in the pilot trial showed promising results, more research is needed to establish the underlying microbiome dysbiosis in individuals with this condition. Microbiome sequencing of healthy individuals may help identify causal factors and improve personalized treatment options in the future.
